Vital signs monitoring in a multi-specialty unit

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Karen Schaak, RN, BS, CMSRN, OCN

Charge Nurse, Saratoga Hospital

Q. What is your role at Saratoga Hospital?

My role as a clinical coordinator is supervising and overseeing the nursing staff and organizing the flow of the floor on a day-to-day basis under the general direction of my director. A lot of the focus is on patient safety, patient satisfaction and improving care. It is a very large, multi-specialty unit of 41 beds. We have a mix of medical-surgical patients - oncology patients, hospice patients and pediatrics. It's a vast variety of patients that we have, which is great. It's one of the things that I love most about where I work.

Q. What are the different types of care that you provide your patients?

A nurse may have a respiratory patient who is getting continuous nebulizer treatments and respiratory treatments throughout the day. Then she may have an oncology patient that's receiving their first dose of chemotherapy. She may also have a detox patient that you're monitoring very closely and helping through that withdrawal period. And then she may have a surgical patient, somebody who's just come back from having a major surgery. So, it's such a huge variety and you're constantly kept on your toes for that reason. But I think that that's one thing that's made our nurses some of the best.

Q. How does technology like Guardian help you do your job?

When we went live with the Guardian system, we went live with our vital sign integration at the same time. Our patient care assistants are the ones taking the patients' vital signs, and then based on a patient's vitals, they're giving them a score. The Guardian system aids in identifying subtle signs of deterioration in a patient’s condition. So it'll notify the staff to changes in a patient’s condition, and then we can put interventions into place. The hospital developed a whole workflow of steps that we follow if a patient starts scoring - increasing the assessments, increasing the vital signs, notifying the provider, notifying the rapid response team.

Our unit is the exact type of unit that benefits from this system, being that it's such a multi-specialty unit. The nurses are getting more and more work: they're getting more things thrown at them all day long, so having a system like this put into place allows them to tell which patients they may need to pay closer attention to.

Q. How did you monitor a patient’s deterioration before this kind of technology?

We'd generally do a patient's vital signs every four hours, which was done by the patient care assistants. We can't do our jobs without them, but the nurse constantly has to remember to go in and look at those vital signs, which will have been documented. So, by having the Guardian system in place, all of that information is in front of you, so you're not constantly having to log into the system and pull up the vital signs. It's all there.

Q. Do you and your colleagues feel supported in the work you do?

You do feel as though there is a ‘trickle-down’ effect - the fact that the [Saratoga Hospital] management supports this technology and that they spoke to the CEO, and then the CNO. They're trying to make our jobs easier, and they're listening to us when we tell them there is a better way of doing something, which makes you feel part of a system that supports and respects what you do.

See how Saratoga Hospital

Reduced codeson the ward.

The hospital developed a whole workflow of steps that we follow if a patient starts scoring.”

Results are specific to the institution where they were obtained and may not reflect the results achievable at other institutions.

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